Functional electrical therapy: retraining grasping in spinal cord injury

Abstract

Objective: To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics. Study design: Randomized intervention-versus-control trial. Setting: Rehabilitation hospital for spinal cord injury in Toronto, Canada. Methods: A total of 21 people with new spinal cord injuries ranging from C3 to C7 were randomly assigned to two groups: Control (N ¼ 9) and Intervention (N ¼ 12). The intervention was functional electrical therapy, which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and/or assist grasping movements. It was applied by registered Occupational Therapists in a clinical setting. Main outcome measures were: Functional Independence Measure (FIM), Spinal Cord Independence Measure (SCIM), and the Rehabilitation Engineering Laboratory Hand Function Test. Consumer perceptions of functional electrical therapy were assessed via qualitative interviews. Results: Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants. Consumer perceptions were positive, including improved Activities of Daily Living and self-satisfaction. Conclusion: Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia. It can be implemented by occupational therapists in a clinical setting. Further research is required to establish suitable indications for participant selection. In addition, a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy.

A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation

“…1 The validity, reliability, and advantages of the first two versions (SCIM I and SCIM II) have been shown in several publications, [1][2][3][4][5][6][7] demonstrating that SCIM II can be used for clinical purposes and outcome assessment in research. 8 Following an in-depth psychometric analysis of SCIM II through Rasch modeling, 1 comments by staff members and experts from several countries, and the need to address intercultural biases, a third version (SCIM III) was formulated. The SCIM III scale, presented in the Appendix, is a profile comprising three complementary subscales consisting of 6, 4, and 9 items, respectively.…”

Control of a neuroprosthesis for grasping using off-line classification of electrocorticographic signals: case study

“…16 He was able to use his arms and wrists but had no hand movement. He gave written and informed consent to participate in this study as required and approved by the Toronto Rehabilitation Institute Research Ethics Board.…”

The Graded Redefined Assessment of Strength Sensibility and Prehension: Reliability and Validity

“…Small gains in upper extremity function can significantly enhance the quality of life (Anderson, 2004;Snoek et al, 2005) for this population. Thus there are many efforts focused on the development of methods to restore upper limb function after SCI (Popovic et al, 2006;Prochazka et al, 1997;Taylor et al, 2002).…”